Case:Merlyn
Caution About This Case Study For those not experienced in feline diabetes (newbies): When I was giving Merlyn insulin shots, I would shoot at lower numbers than most because I knew more or less how he responded to Lantus and was trying for tighter regulation (the Lantus curve was very shallow for Merlyn). Please do not do this before discussing with your vet and only when you have a lot of data and/or experience. See the FAQs at the link below Feline Diabetes Message Board FAQs for info on what to do with lower than normal preshot levels. Remission Information Merlyn's last shot of insulin (so far! ANTIJINX!) was May 9th 2005! We are at the falls!! Of interest to other seeking remission/diet control with their cats, I regularly test and curve Merlyn even though he is not longer on exogenous insulin. Background I am Lisa in SF CA, Mombean to 3 kitties. Started volunteering at shelter 8mos after adopting Janeway, working there for 4 yrs now. Civies Janeway (16yrs, brown tabby girl, first cat, adopted in 97), Conor (9yrs cream tabby boy, 2nd cat, adopted 9 months after Janeway), and Merlyn, my diabetic cat. I fell in love with Merlyn on Petfinder.orgPetfinder.org Homepage, and begged until I got a ride to Sacramento from a dear friend to go get him. He was/is perfect for my other 2..so he joined us 2/6/03.He is 15 yrs 1 mo (est) old.. a red tabby boy. Merlyn has stomatitis and feline odontoclastic resorptive lesions (FORL)Petsmile.org-Feline Odontoclastic Resorptive Lesions (FORLs), and he had a chronically infected big toe as a result of prior declawing. I dont know how long he was in pain with that. Toe amputated in July of O3. Was given one 3 week course of prednisolone for the stomatitis and 2 weeks later, he was diagnosed with diabetes. * Diabetes DX April 04,(BG 523) * Hills M/D dry food slowly switched on DX. * Glipizide for 2 months, some improvement not enough, started U40 PZI Vet 6/16/04. Experience with IDEXX PZI (PZI Vet) Merlyns response on PZI Vet was very inconsistent with duration, overlap was a huge problem, double peaks when on 2U, too low for my comfort and the preshots never came down. The shots merge together leading to WONKY numbers. So when there's more than one shot working, low numbers for a while, then almost no insulin working and higher numbers for a while, then middling numbers for a while, and the whole thing started again. No predictable peak. PZI numbers in FDMB Profile ArchiveFDMB's Profile Archive Lisa & Merlyn. Current Information * Using Ascensia Contour meter and love it! * No obvious neuropathy, does have some arthritis. * 9/23/04 started 2 Zukes hip action treats per day. Started methyl-B12 (12/2/04) as precaution and it has made a huge difference, he is now (1/17/05) able to jump on tree that he couldnt before. * Was feeding 1/8 cup m/d dry am/pm and 1 Nutromax pouch am/pm. *12/19/04 Off dry food totally. Just eating Nutro pouches. 1-1.5 per meal. * 1/30/05 Merlyn has decided to eat Wellness canned "sometimes" ; as well as Nutro pouches. (lower carb ones) *Mid April 05 added Triumph pouches rotated in with Nutro. eating 2 pouches per day References Lantus 2004 Started Lantus 1U BID 11/1/04 11/1 AM PS 392 +4 307 +8 364 PM PS 399 11/2 AM PS 346/+4 390/PM PS 288 11/3 AM PS 299/PM PS 254/ +5 326 11/4 AM PS 429/+5.25 322/PM PS 368 11/5 AM PS 377/PM PS 368 11/6 AM PS 324/ PM PS 352 11/7 AM PS 377/ PM PS 294 11/8 AM PS 465/ PM PS 341/ +5 322 11/9 AM PS 404/PM PS 311 11/10 AM PS 359 +2 346 +4 283 +6 219 +8 231 +10 308 +11 297 11/11 AM PS 335/PM PS 257 11/12 AM PS 381/PM PS 368 11/13 AM PS 384/PM PS 326 Increase to 1.5 Units Lantus 11/14 AM PS 367/ PM PS 186!! shot full dose +2 283 +4 380 +6 379 +8 354 11/15 AM PS 383/PM PS 268 11/16 AM PS 314/PM PS 409 (mopey in bathroom) 11/17 AM PS 390 (ate bit Js wellness, mopey after shot) +3 365 +6.50 320 +9 337 +10.75 322 (PM PS) 11/18 AM PS 292/+6 275/PM PS 190(full dose) +3 179 +4.5 146 +6 130 +7 129 +9.5 119 11/19 AM PS 189 only 1U/PM PS 397(:( wrong dish,ate 1/8?hi carb dry) 11/20 AM PS 253/PM PS 354 11/21 AM PS 247/PM PS 363 11/22 AM PS 420/PM PS 261 (cranky am)/+5.5 299 11/23 AM PS 391/+6.75 432/PM PS 404 11/24 AM PS 246/PM PS 151/+2 230 11/25 AM PS 264/PM PS 311 11/26 AM PS 288/PM PS 377 11/27 AM PS 390/PM PS 257 +4 133 +5.75 135 11/28 AM PS 210/in 45mins 282/PM PS 195/+4 439 11/29 AM PS 385/PM PS 163/ +4 172 11/30 AM PS 186/PM PS 210/ +4.25 299 12/1 AM PS 388/+6.5 403/ PM PS 294 12/2 AM PS 307/ +6 303/ PM PS 309 Started MethylB-12 today..PM 12/3 AM PS 376/ PM PS 431/ +5 food vomit 317 12/4 AM PS 262/ PM PS 157/ +6 161 12/5 +11 114/ AM PS (+12) 200/PM PS 398/ +4 326 12/6 AM PS 281/PM PS 295 12/7 AM PS 306/ PM PS 172/ +2.25 276 PU/PD great today, 3 pee clumps! +2.25 276 +4 226 +6 156 +8 121 +9.5 132 12/8 AM PS 209/went to vet BP for dental/ PM PS 175 STARTING 1.75 U Lantus BID 12/9 AM PS 444/ +3.25 406/PM PS 294/+4 350 12/10 AM PS 345/PM PS 82!!!wait 1 hr 113 full dose/+2.25 222 12/11 AM PS 394/PM PS 344/_4 376 12/12 AM PS 355/PM PS 146/+4 315 12/13 AM PS 300/PM PS 320/+6 352 12/14 AM PS 325/ +7 320/PM PS 101, wait 1 hr 120/+3 114 12/15 AM BG 244/no insulin am Dental one extraction/ PM PS 456/just nibbling/ wait 1.25 hrs, gave 1 unit +2.25 Vomit +3.5 63 +4.25 54 Karo on gums high carb wellness lite +5 56 +6.25 65 +7.25 76 12/16 AM PS 97/+13 167-1U Lantus +1.5 ate rest of dry food +3 152 PM PS 220 +3.25 218 12/17 AM PS 217/+6.25 275/PM PS 310/+5 148 12/18 AM PS 189 +2 299 +6 346 PM PS 355 not wanting his dry food, ate all wet. 12/19 AM PS 392/PM PS 388 (change to 1.5 Nutro pouches am pm no dry) 12/20 AM PS 181/PM PS 153/+ 3.5 308 12/21 AM PS 387/PM PS 231/+ 2 295 12/22 AM PS 313/PM PS 240 12/23 AM PS 198 +2 140 +4 75!! +4.5 67 3 crunchies (wellness lite dry) +5 61 10 crunchies +5.5 61 +6.25 65 +7 76 +8 74 +9.5 65 +10.5 68 foodies +11.75 122 Gave Point 5 units Lantus, +1 gave him more food +2.25 148 +4.5 140 +5.75 119 REDUCING DOSE TO 1.25U Lantus BID 12/24 AM PS 234/PM PS 271 +2 317 +4.5 176 and hungry-gave chicken livalittles +6 227 12/25 AM PS 310/PM PS 330/+6 325 12/26 AM PS 388/PM PS 117/+3 185 12/27 AM PS 311/PM PS 142/+7 118 12/28 AM PS 194/PM PS 262/+5.45 149 12/29 AM PS 189/PM PS 217 12/30 AM PS 343/PM PS 136/+2.25 227 (off food a bit, brought home new suitcase) 12/31 AM PS 324/+7.5 104/PM PS 96 +2.25 84 +4 59 25-30 wellness lite kibbles +4.75 67 +6 102 2005 HAPPY NEW YEAR 2005 REDUCING DOSE TO 1unit lantus BID 1/1 AM PS 258/+7.75 165/PM PS 155/+5.5 201 1/2 AM PS 321/+3.25 202 and very hungry/PM PS 86!!/+4 188 Vacation +catsitter til pm 1/16 1/3 AM PS 207/PM PS 198 1/4 AM PS 127/PM PS 260 1/5 AM PS 363/PM PS 190 1/6 AM PS 204/PM PS 212 1/7 AM PS 190/PM PS 109 (civie crunchies-peppy overnight!) 1/8 AM PS 111(tsp Karo in food)/in 1 hour 209/+3 293/PM PS 144 1/9 AM PS 337(some civie crunchies)/+10 175/PM PS 212 1/10 AM PS 122/in 1 hr 159/PM PS 146 1/11 AM PS 142(some civie crunchies)/PM PS 318 1/12 AM PS 130/PM PS 143 1/13 AM PS 210 (overslept)/PM PS 126 1/14 AM PS 229/PM PS 238 1/15 AM PS 192/PM PS 262 1/16 AM PS 325/PM PS 121 1/17 AM PS 223 +4.25 very hungry, tested at 40!!! inhaled 3oz Nutro pouch +5 58 +6 64 +8.25 73 +10 98 +11 PM PS 75 No shot DOSE REDUCTION TO POINT 75 1/18 +24 195/+7.5 106/PM PS 108 1/19 AM PS 303/+3 264/PM PS 230 1/20 AM PS 258/+8 68!!/PM PS 135 DECREASE TO .5 UNITS PM SHOT 1/21 AM PS 196/PM PS 340 1/22 AM PS 164/PM PS 168 1/23 AM PS 108/PM PS 175/+5 90 1/24 AM PS 158/PM PS 254 1/25 AM PS 104/PM PS 184/+3.5 93 1/26 AM PS 216 +5 111 +7 105 PM PS 143 +1.5 vomit all over (added canned nutro to food:() +2 171 ate 3oz pouch btwn +2 and +4 1/27 AM PS 123/+5.25 85/PM PS 130 (started offering 3 pouches or 1/4can Wellness 1/28 AM PS 133/ PM PS 122 1/29 AM PS 215/ PM PS 137 1/30 AM PS 117/ PM PS 277/+5.75 68/+6.5 93 offering Wellness wet too,each meal 1/31 AM PS 196/ PM PS 231/+3.5 95/+5.5 117 2/1 AM PS 134/ PM PS 249/+3.5 189 2/2 AM PS 142 +2 122 +4 66 +5 64 +7 83 +9 77 +11 PM PS 119 2/3 AM PS 211/+6 96/+10.5 97/PM PS 119 2/4 AM PS 155/+11 105/ PM PS (+12) 115/+6 76 2/5 AM PS 162/PM PS 117/+4 70/+5.5 72/+6.5 84 2/6 AM PS 145/PM PS 133/ +3.5 95 2/7 AM PS 166/PM PS 101 1h40m later post food 175,FD/+3.5 158 2/8 AM PS 172/PM PS 133/+4.5 95 2/9 AM PS 170/+3 233/+7 160/PM PS 161/+5.25 130 2/10 AM PS 221/PM PS 167/+5.5 234 2/11 AM PS 120/PM PS 200 2/12 AM PS 118/PM PS 198/+5 89 2/13 AM PS 149/PM PS 124/+4 228 2/14 AM PS 161/PM PS 161 2/15 AM PS 186/PM PS 107 2/16 AM PS 193/+4.5 155/+8 97/PM PS 129/+7 191 2/17 AM PS 209/+6.5 145/PM PS 101/+4 182/+7 84 2/18 AM PS 75 (no shot)/+18.5 132/+24 286 2/19 AM PS 94/+11.5 175 (skinny)PM PS 269 2/20 AM PS 112/PM PS 142/+4.25 72/+5.25 85/+5.75 70 (nutro/triumph starts here) 2/21 AM PS 141/PM PS 141/+ 5 218 2/22 AM PS 140/PM PS 220/+5.75 65 2/23 AM PS 150 (just nutro) +3 96 +4.5 71 +5.5 61 +7.5 70 +9.75 108 PM PS 109 + 5.25 113 2/24 AM PS 136/ +2.5 105/PM PS 107 2/25 AM PS 139/+5.25 70/+7 92/PM PS 131 2/26 AM PS 112/PM PS 163/+5.5 91 2/27 AM PS 144/PM PS 112/+4 192 2/28 AM PS 161/PM PS 208 ate some civie high carb dry 3/1 AM PS 108/PM PS 127/+4 248!!!!nibbles of wellness turk/salmon! 3/2 AM PS 189/+4 129/PM PS 127 3/3 AM PS 124/+4.75 62/+6 91/PM PS 154/+4 197 3/4 AM PS 149/PM PS 118/+4.25 105 3/5 AM PS 172/PM PS 119/+5 142 3/6 AM PS 170/PM PS 146 (nibbled some of Js dry) 3/7 AM PS 189/PM PS 190/+4.25 157 3/8 AM PS 258/+4.5 191/PM PS 147/+5.25 175 3/9 AM PS 189/+5.75 120/PM PS 147/+5.5 239 3/10 AM PS 187/+3 141/+8.5 87/PM PS 124 3/11 AM PS 145/PM PS 222 3/12 AM PS 117/PM PS 121 3/13 AM PS 143/PM PS 111/+4.5 105 3/14 AM PS 183/PM PS 137/+6.5 64 3/15 AM PS 144/PM PS 146 (feisty bitey tonight) 3/16 AM PS 108 +3 121 +5 96 +7 116 +9 113 +11 118 (pm ps) 3/17 AM PS 200/+2 179/PM PS 127 3/18 AM PS 121/PM PS 196 3/19 AM PS 155/PM PS 148/+3.75 242 (shot 45mins late,regurg preshot,ate less after that.) 3/20 AM PS 150/PM PS 269 (shot point 75 pm dose) 3/21 AM PS 104/PM PS 174/+4.5 158 3/22 AM PS 153/PM PS 136/+5 176 3/23 AM PS 183(shot point 75) +4 48 (fed half Nutro pouch) +5 59 +7 56 +8.25 60 +11 120 (PM PS) +4.25 189 3/24 AM PS 155 +2 169 +5 64 +7 75 PM PS 126 3/25 AM PS 131/PM PS 147 3/26 AM PS 191/PM PS 133/+4 128 (vomit probably J) 3/27 AM PS 128/PM PS 202 3/28 AM PS 175/PM PS 157/+4 215 3/29 AM PS 136/PM PS 113 3/30 AM PS 115 +3 117 +7 112 PM PS 149 +7.5 109 3/31 AM PS 163/+5.25 92/PM PS 115 4/1 AM PS 122/PM PS 136/+4 203 4/2 AM PS 142/PM PS 181 (been coughing? hairball?) pm shot late 4/3 AM PS 95/after 1h+food 145/PM PS 132 time change, lose an hour. 4/4 AM PS 105/PM PS 112/+5 66/+6.5 68 4/5 AM PS 87/wait 1h15m after food 96..no juice/PM PS 109!/+24.5 186 Experiment without insulin 4/6 AM PS 112 +13.25 93 +15 102 +17 100 +19.25 96 +21 129 PM PS 124 (+22) +24 194 +27 195 +29 140 4/7 AM PS 111(+34.5) +37 156 +39 94 +43 144 PM PS 147 (+47) experiment over..reinstituting .5 units bid Lantus. 4/8 AM PS 188/+4 112/+7.5 74/PM PS 159 4/9 AM PS 106Iskinny half/PM PS 162 4/10 AM PS 126/PM PS 103/+5 81 4/11 AM PS 117/PM PS 144/+6.5 61 4/12 AM PS 133/PM PS 137 4/13 AM PS 133 +3 130 +5.5 55 +6.5 84 +9.5 94 PM PS 124 (ate some high carb dry/wellness lite after this) 4/14 AM PS 112/+6 108/PM PS 112/+3 157 4/15 AM PS 95/1 hour later shot .25 at 132/PM PS 182 4/16 AM PS 130/PM PS 144 4/17 AM PS 98 (ate extra food-shot skinny half)/PM PS 121 4/18 AM PS 162/PM PS 127 4/19 AM PS 102/PM PS 158(ate some HiCarb dry/+5 114 4/20 AM PS 148 +3 107 +5.25 72 +7 80 4/21 AM PS 112/P PS 116 4/22 AM PS 120 (ate 1/4 can WTS-1/8 cup hicarb dry/PM PS 303!! DRY food! 4/23 AM PS 185/PM PS 133/+5 90 4/24 AM PS 125/PM PS 116 4/25 AM PS 87 no shot/PM PS 121 ate some dry!!ARrgg 4/26 AM PS 172/PM PS 83 no shot Vacation-Catsitter = no insulin under 150 bg 4/27 AM PS 119 no shot/PM PS 104 no shot/2.5 hrs later 167 still NS 4/28 AM PS 144 no shot/PM PS 185 4/29 AM PS 101 no shot/pM PS 193 4/30 AM PS 112 no shot/PM PS 199 5/1 AM PS 105 no shot/PM PS 164 (mom home) 5/2 AM PS 83/ 1 hour later 113 .25U/ PM PS 107 (.25U) Reduced to point 25 units BID as best I can eyeball it. 5/3 AM PS 108/PM PS 110 5/4 AM PS 122 +2 98 +4.5 72 +6 86 +7 87 +9 101 +11(PS) 95 No shot +15.25 92! 5/5 AM PS 113 +2.5 128 +9.5 129 PM PS 177 (shot point 50) +3.5 73 fed 1/2 3oz Turkey wellness midnight so I could go to bed 5/6 AM PS 89 (no shot) PM PS 144 +3.5 58 +4.5 73 +5.5 74 5/7 AM PS 87 (no shot)/PM PS 152/+4 72/+5.5 79 5/8 AM PS 130 (no shot)/PM PS 125 (no shot) 5/9 AM PS 121 (no shot/PM PS 152 (.25) LAST SHOT SO FAR!!! These numbers are at the time a PS would have been taken..but no insulin 5/10 AM PS 102 (no shot)/PM PS 115(no shot) 5/11 AM PS 130/+5.5 after PS 59!/PM PS 97 5/12 AM PS 100/PM PS 60 5/13 AM PS 125/PM PS 127 5/14 AM PS 89 /PM PS 95 5/15 AM PS 105/PM PS 113 5/16 AM PS 98/ PM PS 102 5/17 AM PS 87/ PM PS 131/+4.5 hrs after PS 91 5/18 AM PS 92/ +6 after PS 68/PM PS 104 playing with "da bird" 5/19 AM PS 90/PM PS 106 5/20 AM PS 117/ PM PS 107 5/21 AM PS 101/ PM PS 115 /+ 5 after PS 63 next to toilet, hot in apt 5/22 AM PS 91/ PM PS 120 5/23 AM PS 97/ PM PS 126 5/24 AM PS 80/ PM PS 91 5/25 AM PS 90/ PM PS 103 Adding wellness for variety 5/26 AM PS 111/PM PS 90 5/27 AM PS 108/PM PS 118 5/28 AM PS 104/PM PS 127 5/29 AM PS 102/PM PS 97/+6 after PS 91 5/30 AM PS 110/PM PS 85 5/31 AM PS 94 /PM PS 88 6/1 AM PS 88 /PM PS 109 6/2 AM PS 97 /PM PS 101 6/3 AM PS 119/PM PS 104 6/4 AM PS 119/PM PS 112 no more wellness start6/5..numbers better after.. 6/5 AM PS 99 /PM PS 76 6/6 AM PS 70 /PM PS 89 6/7 AM PS 63 /PM PS 75 6/8 AM PS NA /PM PS 68 grouchy, missed am 6/9 AM PS 102/PM PS 92 6/10 AM PS 83 /PM PS 99 6/11 AM PS 98 /PM PS 92 6/12 AM PS 79 /PM PS 82 6/13 AM PS 78 /PM PS 77 6/14 AM PS 84 /PM PS 89 6/15 AM PS 121 (overslept, 1hr 20mins) +2 108 (after PS) +5.25 65 +8 64 PM PS 65 TESTING ONCE A DAY MOSTLY 6/16 6:30A 86 6/17 6:30A 71 6/18 6:20A 72 6/19 6:25A 75 6/20 7:35A 86 6/21 7:10P 88 6/22 8:05A 98 6/23 7:00P 86 6/24 7:20A 88 6/25 7:25A 96 6/26 7:50P 88 6/27 7:50P 97 6/28 7:30A 92 6/29 8:10A 81 6/30 7:25A 83/7:15P 80 7/01 6:30A 80/6:10P 103 7/02 7:30A 84 7/03 7:30A 87 7/04 7:20A 77 7/05 7:25A 102 7/06 7:25A 76 +2.5 161! food spike +5.5 84 +9 73 +12 66 Ran out of strips 7/23 7:30A 99 7/24 7:30A 75 7/25 7:30A 63 7/28 7:00A 84 7/29 7:35A 94 7/30 7:30A 106 7/31 7:00P 71 FIRST 100ccs fluids,after eating (2x a week) 8/1 7:30A 80 8/3 7:20A 65 100ccs fluids at 11:30 pm 8/4 10:15A 84 8/5 7:30A 74 8/7 7:10A 80 8/8 7:22A 98 8/9 7:30P 61 8/11 8:30A 91/6:30P 76 8/12 5:30P 95 8/14 5:20A 77 8/15 7:30A 80 8/19 5:15A 81 8/22 7:20A 82 8/25 7:30A 86 +2 101 +4.5 69 +6.5 78 +9.5 84 +10.5 77 (6:30P) 9/10 3:40P 75 9/26 8:20P 89 (off food) 9/27 8:20A 120 (only ate 1/4 pouch) 7:45P 78 10/09 6:15A 76 10/13 2:00P 63 10/17 8:35A 118 (+1 after food) 10/20 10:40A 98 (+2.5 after food) 10/23 10:30P 95 (Vomit food 10:15P) 11/17 7:45A 78/9:45A 90/1:45P 79 12/1 8:10A 78 (prefood) 10:15A 94 12:45P 43 2:20P 79 4:50P 77 6:30P 56 (prefood) Further Reading More at His FDMB profile Category:Feline cases Category: Lantus cases Category:low-carb cases Category:Male cases Category:Neuropathy cases Category:Oral med cases Category:Overlap cases Category:PZI Vet cases Category:Regulated cases Category:Remission cases Category:Tight Regulation cases Category:UTI cases Category:Feline male cases Category:Feline Lantus users Category:Feline low-carb cases Category:Feline regulated cases Category:Feline tight regulation cases Category:Feline neuropathy cases Category:Feline UTI cases Category:Feline Oral med cases